Which Variations of a Brief Cognitive Bias Modification Session for Interpretations Lead to the Strongest Effects?

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ORIGINAL ARTICLE

Which Variations of a Brief Cognitive Bias Modification Session for Interpretations Lead to the Strongest Effects? Shari A. Steinman1   · Nauder Namaky2 · Sarah L. Toton3 · Emily E. E. Meissel4 · Austin T. St. John2 · Nha‑Han Pham2 · Alexandra Werntz2 · Tara L. Valladares2 · Eugenia I. Gorlin5 · Sarai Arbus2 · Miranda Beltzer2 · Alexandra Soroka2 · Bethany A. Teachman2 Accepted: 15 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020

Abstract Background  Brief computerized programs that train less threatening interpretations (termed Cognitive Bias Modification for Interpretations, or CBM-I) can shift interpretation biases and subsequent anxiety symptoms. However, results have been inconsistent, particularly for studies conducted over the Internet. Methods  The current exploratory study tests 13 variations of a single brief session of CBM-I, a non-CBM-I cognitive flexibility condition, a neutral condition, and a no task control condition in an analogue sample with moderate to severe anxiety. Results  Results suggest that all conditions, except the neutral scenarios condition and the alternative way to improve cognitive flexibility, led to changes in interpretations (when compared to the no task control condition). Only conditions geared toward increasing imagery during CBM-I and targeting flexibility related to emotional material differed from the no task control condition on other post-training measures. Conclusions  Presenting valenced interpretations of ambiguous information during brief CBM-I, regardless of the format, can lead to changes in interpretation bias. However, most conditions did not differ from the no task control condition on other post-training assessments (and differences that did occur may be due to chance). Future trials should consider further testing of CBM-I that targets flexibility related to emotional material, and should include an increased number of sessions and trials. Keywords  Information processing · Anxiety · Cognition · Cognitive bias modification · Internet

Introduction

Electronic supplementary material  The online version of this article (https​://doi.org/10.1007/s1060​8-020-10168​-3) contains supplementary material, which is available to authorized users. * Shari A. Steinman [email protected] 1



Department of Psychology, West Virginia University, PO Box 6040, Morgantown, WV 26506, USA

2



University of Virginia, Charlottesville, USA

3

Caveon Test Security, Midvale, USA

4

San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, USA

5

Yeshiva University, New York, USA





Anxious individuals tend to interpret ambiguous information in a threatening way (Mathews and MacLeod 2005). According to cognitive models, this interpretation bias causes anxiety (Beck and Clark 1997; Clark and Beck 2010) To test this claim, researchers developed brief paradigms, called Cognitive Bias Modification for Interpretations (CBM-I), designed to shift interpretations